Something that is rarely considered as a possible diagnosis for ME or CFS is bacterial infections.

Differential diagnosis for ME and CFS

• Something that is rarely considered as a possible diagnosis for ME or CFS is bacterial infections. 

  There are a number of stealth pathogens capable of causing symptoms like we have with ME/CFS but possibly the most likely culprit that is overlooked by doctors is Borrelia (Lyme Disease).
  
  This can be passed on from a tick bite but we are not always aware of the poppy seed sized tick that can pass on this infection.
  
  Not everyone gets the typical Bulls eye rash many don't even get a rash but if you do you are infected.
  
  Blood tests are antibody tests and so can miss many cases - due to species and strain variation 100's of different ones but the tests only look for one strain plus a couple of species specific bands here in Europe. If a person's immune system has been affected by the immunosuppression of the tick saliva or our own health or Steroid treatments than testing is unlikely to be helpful - it certainly can't rule out the possibility of having Lyme Disease.
  
  Essentially it is a clinical diagnosis but most doctors are not sufficiently knowledgeable or experienced to make that call.
  
  So do your research and a good place to start would be charity website ( Also useful for those not in UK)
  http://www.lymediseaseaction.org.uk/
  
  Their latest leaflet lists many symptoms those with ME/CFS suffer http://www.lymediseaseaction.org.uk/wp-content/uploads/2013/05/LDA003-2-web-version.pdf
  
  There are guidelines DBG or German that are well referenced and helpful http://www.borreliose-gesellschaft.de/Texte/guidelines.pdf
  
  My symptoms were like so many everyone describes on this Facebook page and I was diagnosed with Fibro, ME/CFS, Musculo skeletal Disease and PMR- it took 4 years and a chance course of antibiotics for GP to consider Lyme Disease, eventually I recovered on antibiotics  see my story on my blog right hand column
   http://lookingatlyme.blogspot.co.uk/
  
  All my symptoms could be described as inflammation - what causes that inflammation needs to be considered, in my case it was a bacterial infection. Most doctors do not consider this as a differential diagnosis because there has been a concerted effort by certain people with conflicts of interest and financial interests in suppressing much of the evolving research about Lyme disease. http://www.poughkeepsiejournal.com/article/20130520/NEWS01/305190007/ICYMI-VIDEO-Chronic-Lyme-disease-real
   Following the links in this leads to e mails from HPA expert on Lyme that shows she was very much involved in the Socio political spin on denying the evolving scientific data. She is now retired.
  
  Now I am not suggesting everyone with ME/CFS has Lyme Disease but in view of the controversy you do need to look into this.
  
  Lots of fascinating reading but the most important thing is that something is causing your health problem so you need to do your research and discuss with your doctors. 

  
  

  Joanne